all-ceramic prosthetic rehabilitation of a worn dentition: use of a distal cantilever. two-year follow-up

the rehabilitation of heavily abraded occlusion in patients with parafunctional habits is a restorative challenge to the dentist. use of all-ceramic systems in such cases is widely considered, but uncertainty over their resistance hinders their broad use. the authors would like to illustrate a possible approach by mixing two all-ceramic systems based on zirconium dioxide and lithium disilicate. a 48-year-old female patient attended with reduced vertical dimension in a full dentition. she suffered from craniomandibular (cmd) pain and desired an esthetic rehabilitation. prosthodontic treatment was started in a pain-free condition, after correction of the vertical dimension with an occlusal splint, over four months. determination of the treatment was based on the clinical fi ndings: ips e.max® zircad frameworks veneered with ips e.max® ceram were used for discolored retainers or subgingival fi nishing lines. all the rest received ips e.max® press crowns. a zirconiia-based, single-tooth-retained distal cantilever reconstruction was used to replace a missing second molar. no technical or biological complication was observed 24 months after treatment. the patient was highly satisfi ed and pain-free. key words: computer-aided design/computer-aided manufacturing, cerec, multilink, relyx unicem